What is Failed Back Surgery Syndrome?

Failed back surgery syndrome, (FBSS) is a term referring to the chronic and severe pain a patient can experience after unsuccessful surgery. FBSS affects up to 40 percent of patients who have had traditional open back or minimally invasive spine surgery. Often surgery is indicated for an identifiable source of pain due to pinched nerve root or an unstable and painful joint. However, back pain can have many causes and accurate identification of the source of pain is complicated. Too often, x-ray and Magnetic resonance imaging (MRI) scans do not correlate well with symptoms. Therefore, diagnostic injections are often warranted and assist in making the proper patient selection and spinal level for surgery.

What are the Causes of Failed Back Surgery Syndrome?

Failed back surgery syndrome can result from one of many causes such as:

  • Inaccurate diagnose of the condition(s)
  • Failure resulting from spine fusion
  • Lateral recess stenosis (failure to decompress the area between the midline and lateral aspect of the exiting nerve)
  • Surgery performed at the wrong level of the spine
  • Adjacent segment disease (the development of pain, instability of degenerative conditions at the level above of below the previous surgical site)
  • Scar tissue formation
  • Missed disc fragment, re-herniation of disc or bone spurs still pinching the spinal nerve
  • Nerve damage from surgery

Age

As we age, degenerative changes can occur to our spin. Many people with degenerative disc disease, age with no spinal pain or problems. However, many people suffer daily with pain due to degenerative changes in the disc and spinal column. A bulging disc in an elderly person has chemical alterations to the integrity and cushioning of the disc and it losses moisture and begins to weaken the tough outer annulus fibrosis much like a dry fragile sponge. As a result, disc may herniate or bulge and the disc can lose height effecting the vertebrae and facets causing other spinal issues. The ligaments supporting the spinal column can weaken as well, increasing the likelihood of a bulging disc.

What are the Symptoms of Failed Back Surgery Syndrome?

The pain associated with failed back syndrome varies depending on the surgical procedure performed and the conditions treated. The pain can range from a dull ache to sharp stabbing pain and may be localized to one area of the back or reach into the legs. Patients suffering from FBSS can experience any of the following symptoms:

  • Chronic pain
  • Pain at the adjacent area above or below the previously-treated area
  • Decreased mobility
  • Aching and dull pain in the back, legs, or neck
  • Sharp or stabbing pain
  • Sharp or stabbing pain
  • Increased dependence on pain medicine

What are the Diagnostic & Treatment Options for 
Failed Back Surgery Syndrome?

Minimally Invasive Spine Surgery

  • MIS Microdiscectomy A minimally invasive approach involves a small 15-20mm incision and sequential dilating tubes that gently spread the muscles to afford visualization to the spine. The goal of the technique is decompression of bone or disc that is pressing on the spinal nerves, without a fusion. With this technique, patients have better recovery than traditional open surgery that strips muscle from the bone in order for surgeons to see. Learn More
  • MIS Transforaminal Lumbar Interbody Fusion (TLIF) A minimally invasive approach involves a small 15-20mm incision and sequential dilating tubes that gently spread the muscles to afford visualization to the spine. The goal of the technique is decompression of bone or disc that is pressing on the spinal nerves, without a fusion. With this technique, patients have better recovery than traditional open surgery that strips muscle from the bone in order for surgeons to see. Learn More

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